AFRICA: US cuts to foreign aid hurt countries caught in conflict and crisis

Three months since the Trump administration first suspended all international assistance pending review, the US has terminated much of its funding for global health and humanitarian programs, dismantled the federal government architecture for oversight of these activities, and fired many of the key staff responsible for implementation. Patients around the world are scrambling to understand how they can continue treatment, medical providers are struggling to maintain essential services, and aid groups are sounding the alarm about exploding needs in countries with existing emergencies.

“These sudden cuts by the Trump administration are a human-made disaster for the millions of people struggling to survive amid wars, disease outbreaks, and other emergencies,” said Avril Benoît, CEO of Doctors Without Borders (MSF) in the United States. “We are an emergency response organisation, but we have never seen anything like this massive disruption to global health and humanitarian programs. The risks are catastrophic, especially since people who rely on foreign assistance are already among the most vulnerable in the world.”

The US has long been the leading supporter of global health and humanitarian programs, responsible for around 40 percent of all related funding. These US investments have helped improve the health and well-being of communities around the globe—and totaled less than 1 percent of the annual federal budget.

Abruptly ending this huge proportion of support is already having devastating consequences for people who rely on aid, including those at risk of malnutrition and infectious diseases, and those who are trapped in humanitarian crises around the world. These major cuts to US funding and staffing are part of a broader policy agenda that has far-reaching impacts for people whose access to care is already limited by persecution and discrimination, such as refugees and migrants, civilians caught in conflict, LGBTQI+ people, and anyone who can become pregnant.

The status of even the much-reduced number of remaining US-funded programs is highly uncertain. The administration now plans to extend the initial 90-day review period for foreign aid, which was due to conclude on April 20, by an additional 30 days, according to an internal email from the State Department obtained by the media.

MSF does not accept US government funding, so we are not directly affected by these sweeping changes to international assistance as most other aid organisations are. We remain committed to providing medical care and humanitarian support in more than 70 countries across the world. However, no organisation can do this work alone. We work closely with other health and humanitarian organisations to deliver vital services, and many of our activities involve programs that have been disrupted due to funding cuts. It will be much more difficult and costly to provide care when so many ministries of health have been affected globally and there are fewer community partners overall. We will also be facing fewer places to refer patients for specialised services, as well as shortages and stockouts due to hamstrung supply chains.

Amid ongoing chaos and confusion, our teams are already witnessing some of the life-threatening consequences of the administration’s actions to date. Most recently, the US administration canceled nearly all humanitarian assistance programs in Yemen and Afghanistan, two countries facing some of the most severe humanitarian needs in the world. After years of conflict and compounding crises, an estimated 19.5 million people in Yemen—over half the population— are dependent on aid. The decision to punish civilian populations caught in these two conflicts undermines the principles of humanitarian assistance.

Across the world, MSF teams have witnessed US-funded organisations reducing or cancelling other vital activities–including vaccination campaigns, protection and care for people caught in areas of conflict, sexual and reproductive health services, the provision of clean water, and adequate sanitation services.

“It’s shocking to see the US abandon its leadership role in advancing global health and humanitarian efforts,” Benoît said. “US assistance has been a lifeline for millions of people–while yanking this support will lead to more preventable deaths and untold suffering around the world. We can’t accept this dangerous new normal. We urge the administration and Congress to maintain commitments to support critical global health and humanitarian aid.”

MSF staff taking care of a patient in the Cholera Treatment Centre in Assosa, Malakal. Photographer: Paula Casado Aguirregabiria | Location: South Sudan | Date: 26/11/2024Cold chain room at the MSF base in Kisangani, DRC. Ornella, a pharmacy supervisor, ensures that the vaccine is well preserved. The measles vaccine is very sensitive: its preservation and storage meet very strict cold chain standards. Photographer: Pacom Bagula | Date: 12/03/2021 | Location: DRC

A picture of different medications a person living with HIV may take on a daily basis. Photographer: Michel Lunanga | Location: Kinshasa | Date: 31/08/2022

Jane Rabothata

Communications Specialist, Doctors Without Borders

• jane.rabothata@joburg.msf.org
• 0712873613

About Doctors Without Borders (MSF)

Doctors Without Borders (MSF) is a global network of principled medical and other professionals who specialise in medical humanitarian work, driven by our common humanity and guided by medical ethics. We strive to bring emergency medical care to people caught in conflicts, crises, and disasters in more than 70 countries worldwide.

In South Africa, the organisation is recognised as one of the pioneers of providing Antiretroviral Treatment (ART) in the public sector and started the first HIV programmes in South Africa in 1999. Until today, the focus of MSF’s interventions in the country has primarily been on developing new testing and treatment strategies for HIV/AIDS and TB in Eshowe (Kwa-Zulu Natal) and Khayelitsha (Western Cape).

In Tshwane, we run a migration project, and we offer medical and psychosocial care to migrants, refugees, and asylum seekers, who struggle to access public health services under South Africa’s increasingly restrictive.

Previously we offered free, high-quality, confidential medical care to survivors of SGBV in Rustenburg.

To learn more about our work in South Africa, please visit this page on our website (www.msf.org.za). To support MSF’s work: